tbuckley/cabot-search huggingface dataset:
POS1289 ANALYSIS OF INFECTIOUS SPONDYLODISCITIS: FIVE-YEARS DATA
Authors: B. A. Hiba, B. A. Kaouther, S. Miladi, F. Alia, S. Meriem, L. Souabni, K. Ouenniche, K. Selma, C. Selma, L. Ahmad
Journal: Annals of the Rheumatic Diseases (2022)

Background Spondylodiscitis (SD) is an infection of the vertebral body or disc and may also extend to the epidural space, posterior elements, and paraspinal soft tissues. It is a cause of morbidity and mortality. However, the diagnosis is often delayed because of the non-specific clinical features. Objectives In this study, we aimed to describe the clinical and diagnostic features of infectious SD Methods We conducted a retrospective study including 40 cases of infectious SD, performed over a period of five years (2014-2019). Epidemiological, clinical characteristics, laboratory results and imaging findings were uniformly collected. Results : Of the 40 patients, 37.3% were male. The mean age was 53.3 ± 13.9 years [28-83] and the median Charlson Comorbidity Index was 1. Advanced age, tuberculosis and brucellar contagion were the predominant risk factors. The median duration from onset to diagnosis was 41 days [8-300]. Low back pain (LBP) was the most common symptom (98%). Lumbar spine was the most frequent location (71%). Seven patients had contiguous multiple levels (&gt;2 vertebral bodies). Neurologic symptoms (radicular pain, spinal chord compression, neurologic loss) were observed in 15 patients. The median erythrocyte sedimentation rate was 54 mm/1st h [13-223], the median CRP was 26.3 mg/L [7-387]. Leukopenia (&lt;4000 WBCs/mm3) was found in three patients (9.8%). Magnetic resonance imaging confirmed the diagnosis in all cases, and revealed spinal epiduritis in 17 patients (34.8%), paravertebral abscesses in 11 (20.3%) and spinal cord compression in 4 (7.8%). Pathogens were isolated in 19 cases. Computed tomography-guided percutaneous disc biopsy (PDB) was performed in 16 (53.5%) and was conclusive in (11/15) cases (66.8%). Mycobacterium tuberculosis (MT) was the most common pathogene (46.4%) followed by Brucella (21.4%), Pyogenes (17.8%) and Gram-negative bacteria (14.2%). One patient had both MT and Staphylococcus haemolyticus.Paravertebral abscess formation (19.6%) occurred most frequently in patients with tuberculous SD (P= 0.02). Leucocytosis (&gt;10,000 WBCs/mm3) was significantly higher in patients with Pyogenes SD (p=0.002) than in patients with other types of SD. All patients were treated with antibiotics and only one patient underwent surgical act. The outcome was favourable in 27 cases (86.8%). Conclusion Spondylodiscitis should be considered for all patients presenting with chronic backpain especially when associated with laboratory examination abnormalities. In our study, tuberculous spondylodiscitis was the most frequent, which highlights the fact that osteoarticular tuberculosis remains endemic in developing countries, where it still constitutes a major public health problem Disclosure of Interests None declared
AB0852 Assessment of endothelial dysfunction in spondyloarthritis
Authors: A. Ben Tekaya, T. Mehmli, S. Boukriba, F. Ahmed, O. Saidane, R. Leila, S. Bouden, R. Tekaya, I. Mahmoud, H. Mizouni, L. Abdelmoula
Journal: Annals of the Rheumatic Diseases (2022)

Background Endothelial dysfunction is the earliest step in the pathogenesis of atherosclerosis, preceding structural vascular alterations. Few studies have focused on the endothelial dysfunction in spondyloarthritis. Objectives The aim of our study was to assess endothelial dysfunction using Flow-Mediated dilatation (FMD) in patients with spondyloarthritis. Methods Forty-seven consecutive patients meeting ASAS 2009 criteria for spondyloarthritis and 47 matched healthy subjects were included in the study. Subjects with traditional cardiovascular risk factors were excluded. Sociodemographic, clinical, biological and radiological features related to the disease as well as therapeutics were recorded. FMD was assessed ultrasonographically according to guidelines of American college of cardiology (ACC) (1). Results Spondyloarthritis group included 47 patients with a sex ratio of 2.35 and a median age of 36 years (IQR: 28-46). Median body mass index (BMI) was 24.5 kg/m2 (IQR 25-75%: 20.7-26.8) with no significant difference compared with the control group (p=0.238). Physical examination showed normal values of blood pressure (BP) with a median systolic BP of 121 mmHg (IQR 25-75%: 110-130) and a median diastolic BP of 71 mmHg (IQR 25-75%: 67-78). In laboratory findings, total cholesterol and triglyceride levels were increased in 2 and 3 patients respectively. Median age at onset of SpA was 20 years (IQR 25-75%; 18-32). For disease activity, median CRP level was 6.45 mg (IQR 25-75%: 1.45-19.9) and median ASDAS-CRP and BASDAI were respectively 2.18 (IQR 25-75%: 1.62-2.91) and 2.6 (IQR 25-75%: 1.8-3.8). Median MASES score was 0 (IQR 25-75%; 0-0). Median BASFI and BASMI were 3 (IQR 25-75%; 1.5-5.1) and 1.5 (IQR 25-75%: 0-4). Regarding treatment, 92% of patients were using NSAIDs, csDMARDs (51%) and 38% were on TNF inhibitors. Patients with spondyloarthritis exhibited significantly lower FMD values than healthy age and gender matched controls with a median value of FMD 14.6% (IQR; 9-24) versus 18.8% (IQR; 12.8-23.1%); p=0.008. Conclusion Our study demonstrates impairment of endothelial function in patients with spondyloarthritis compared with healthy population, confirming the accelerated atherosclerosis in spondyloarthritis. References [1]Thijssen DHJ, Bruno RM, van Mil ACCM, Holder SM, Faita F, Greyling A, et al. Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans. Eur Heart J. 2019 Aug 7;40(30):2534–47. Disclosure of Interests None declared
Comparison of Mortality and Hospital Readmissions Among Patients Receiving Virtual Ward Transitional Care vs Usual Postdischarge Care
Authors: Utkarsh Chauhan, Finlay A. McAlister
Journal: JAMA Network Open (2022)

Virtual wards (VWs) include patient assessment in their homes by health care personnel and offer ongoing assessment and case management via home, telephone, and/or clinic visits. The association between VWs and patient outcomes during the transition from the hospital to home are unclear; earlier reviews on this topic have often conflated telemonitoring programs with VW models.To evaluate the use of VW transition systems for community-dwelling individuals after medical discharge.English-language articles indexed in PubMed or Cochrane and published between January 1, 2000, and June 15, 2021.Randomized clinical trials comparing VW care with usual postdischarge care. Studies were stratified by diagnosis.Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline, 2 reviewers independently identified studies and extracted data. DerSimonian-Laird inverse variance weighted random-effects models were used to compute relative risks (RRs) for dichotomous outcomes and mean differences for continuous outcomes.All-cause mortality, hospital readmissions, emergency department visits, health care costs, readmission length of stay, quality of life, and functional status.Twenty-four randomized clinical trials (11 in patients with heart failure, 3 in patients with chronic obstructive pulmonary disease, 4 in patients at high-risk for readmission, and 6 in mixed patient populations) with 10 876 patients were included (20 more trials than earlier reviews). In patients with heart failure, VWs were associated with fewer deaths (RR, 0.86; 95% CI, 0.76-0.97) and fewer readmissions (RR, 0.84; 95% CI, 0.74-0.96). However, similar associations were not seen in randomized clinical trials enrolling patients with other diagnoses (RR, 0.93; 95% CI, 0.83-1.04 for mortality and RR, 0.96; 95% CI, 0.88-1.05 for readmissions). Across all studies, VWs were associated with fewer emergency department visits (RR, 0.83; 95% CI, 0.70-0.98) and shorter readmission lengths of stay (mean difference, -1.94 days; 95% CI, -3.28 to -0.60 days). Three of 7 studies that evaluated health care expenses reported statistically significant lower costs with VW transition systems.Although postdischarge VW interventions appear to be associated with fewer subsequent emergency department visits, shorter readmission lengths of stay, and lower health care costs, fewer deaths and readmissions were seen only in trials enrolling patients with heart failure.
AB0996 The possibility of long-term pain control in patients with osteoarthritis
Authors: E. Polishchuk, A. Karateev, A. Potapova, V. Amirdzhanova
Journal: Annals of the Rheumatic Diseases (2022)

Background In some patients with osteoarthritis (OA), moderate or severe joint pain may persist for a long time and functional limitations may increase, which requires long-term administration of nonsteroidal anti-inflammatory drugs (NSAIDs). Objectives To evaluate the efficacy and safety of long-term use of NSAIDs in patients with OA in real clinical practice. Methods 611 patients with OA (knee or hip) were included in an open observational study. 64.5% were female, mean age 58.3±11.0years. All patients received aceclofenac at a dose of 200 mg / day. Pain at movement was determined on a 10-cm visual analog scale (VAS). The number of patients with severe pain (≥6 cm by VAS) and the number of patients with pain reduction ≥50% were evaluated. The assessment was carried out 2 weeks, 3, 6, 9 and 12 months after the start of therapy. Adverse events were noted at each visit. Results By 12 months of follow-up, 53.3% of patients had completed the study. The mean pain severity at baseline, after 2 weeks, 3, 6, 9 and 12 months was 6,5±1,2; 4,8±1,4; 3,2±1,4; 2,6±1,4; 2,2±1,1; 1,4±1,1 cm VAS (p&lt;0.05). The number of patients with severe pain decreased from 77.8% to 24,9%, 2,9%, 2,3%, 0,9% and 0%. The number of patients with pain reduction ≥50% was 12,0%, 65,1%, 81,0%, 88,5% and 84.0%. Adverse events were observed in about 30% of patients, mainly mild or moderate dyspepsia (11.1%- 23.3%) and arterial hypertension (7.1% - 10.9%). No serious complications were recorded. Conclusion Taking into account the large number of drop-outs from the study (46.7%), approximately half of the patients can have long-term pain control with NSAIDs in real clinical practice. Aceclofenac is effective and well tolerated and can be used for long-term pain control in patients with OA. Disclosure of Interests None declared
AB1052 ASSOCIATION BETWEEN BODY MASS INDEX AND HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH GOUT
Authors: I. Orlova, I. Vovk, M. Stanislavchuk
Journal: Annals of the Rheumatic Diseases (2022)

Background Gout is an inflammatory disease that may cause decreased function and health-related quality of life (HRQoL) [1]. In a few studies, it was demonstrated a negative relationship between body mass index (BMI) and HRQoL in individuals with gout; in the others, it was not confirmed. Objectives This study aimed to assess the BMI and quality of life in patients with gout and to value the association between these variables. Methods All 151 patients were male with mean age (M±SD) 52.4±9.2 years. Diagnosis of gout was based on the ACR/EULAR 2015 criteria [2]. Tophi was present in 51 (33.7%), and the median duration of gout was 7 years (25th to 75th interquartile range (IQR), 4 to 14.0). The mean uric acid in serum was (sUA) (M±SD) 477.2 ±120.5 µmol/l. HRQoL was evaluated by the SF-36 and calculated summary physical (PCS) and mental component (MCS) scores of the SF-36. Results About 67.5% of the surveyed patients had BMI &gt; 30 kg/m2, while the average index was 31.9±3.4. The overall median SF-36 PCS score was 33.9 (IQR 28.8 to 38.4), and the overall median SF-36 MCS score was 41.1 (IQR 34.2 to 47.4). Among the eight subscales of SF-36, there was a correlation between BMI and role physical functioning (RP) r = -0.22 (p&lt;0.01), general health (GH) r = -0.17 (p&lt;0.05), but others were statistically not significant (P&gt;0.05). Our analysis showed negative associations between BMI and physical and mental HRQoL. BMI correlated with PCS r = -0.19 (p&lt;0.05) and MCS r = -0.17(p&lt;0.05). Conclusion This analysis provides further evidence to support the injurious effects of obesity on different aspects of health patients with gout and underline the importance of weight loss. References [1]Chandratre, P., Mallen, C., Richardson, J., Muller, S., Hider, S., Rome, K., &amp; Roddy, E. (2018, August). Health-related quality of life in gout in primary care: Baseline findings from a cohort study. In Seminars in arthritis and rheumatism (Vol. 48, No. 1, pp. 61-69). WB Saunders. [2]Neogi, T., Jansen, T. L. T. A., Dalbeth, N., Fransen, J., Schumacher, H. R., Berendsen, D., &amp; Taylor, W. J. (2015). 2015 gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis &amp; rheumatology, 67(10), 2557-2568. Disclosure of Interests None declared
AB0491 MUSCULOSKELETAL INVOLVEMENT, CONFIRMED BY CONTRAST ENHANCED MRI, CONTRIBUTES TO A WORSE HEALTH-RELATED QUALITY OF LIFE IN SLE PATIENTS
Authors: P. Corzo Garcia, I. Carrión Barberà, I. Garcia-Duitama, A. Agustí Claramunt, S. Marsico, J. Monfort, T. C. Salman Monte
Journal: Annals of the Rheumatic Diseases (2022)

Background Joint involvement in SLE is the most frequent manifestation, despite this, its impact on health-related quality of life (HRQoL) has not been well stablished in these patients 1 . Pain, fatigue and functional disability contribute to HRQoL related to SLE 2 . Objectives We aim to study the relation between joint and tendon involvement confirmed by contrasted MRI and these patient related outcomes (PRO). Methods Consecutive SLE patients fulfilling SLICC criteria both symptomatic and asymptomatic for joint involvement were recruited. Gadolinium-enhanced MRI of non-dominant hand/wrist was performed in all subjects for joint and tendon evaluation. Different PRO: numeric scale (NE) of pain (0-10) and fatigue (0-3), Health Assessment Questionnaire (HAQ) and Fatigue Severity Scale (FSS-9) were collected and statistically analysed along with each MRI abnormality. Results 83 subjects were recruited. Patients with synovitis, tenosynovitis, peritendonitis and bone marrow edema reported higher values in pain NE (6.03±2.57 vs 4.26±2.49, p 0.005; 6.56±1.95 vs 4.76±2.75, p 0.017; 8.80±1.30 vs 4.95±2.55, p 0.001; 6.47±2.62 vs 4.83±2.58, p 0.026); patients with synovitis reported higher values in fatigue EN (2.32±0.82 vs 1.91±0.84, p 0.035) and patients with tenosynovitis showed worse FSS-9 (61.50±1.73 vs 45.70±16.80, p 0.015) versus patients who did not show these abnormalities by MRI. Patients with synovitis and peritendonitis had a worse HAQ (1.14±0.69 vs 0.75±0.65, p 0.031; 1.69±0.07 vs 0.90±0.69, p 0.018). Conclusion SLE patients with joint and/or tendon involvement confirmed by contrast enhanced MRI have a worse HRQoL measured by pain, fatigue and functional disability. References [1]Ceccarelli F et al. Joint involvement in systemic lupus erythematosus: From pathogenesis to clinical assessment. Semin Arthritis Rheum. 2017;47:53-64 [2]Piga M et al. Musculoskeletal manifestations as determinants of quality of life impairment in patients with systemic lupus erythematosus. Lupus. 2018 Feb;27(2):190-198 Acknowledgements GSK and societat Catalana de Reumatologia granted this work and we acknowledge them for their collaboration Disclosure of Interests PATRICIA CORZO GARCIA Grant/research support from: GSK, Irene Carrión Barberà: None declared, Ivan Garcia-Duitama: None declared, Anna Agustí Claramunt: None declared, Salvatore Marsico: None declared, Jordi Monfort Grant/research support from: GSK, Tarek Carlos Salman Monte Grant/research support from: GSK
POS0725 VALIDATION OF SJÖGREN’S SYNDROME SCREENING QUESTIONNAIRE (SSSQ) IN A COHORT OF PATIENTS WITH SICCA SYMPTOMS
Authors: K. Perdan-Pirkmajer, K. Fortuna, Z. Teršek, J. Kramarič, A. Hocevar
Journal: Annals of the Rheumatic Diseases (2022)

Background ACR/EULAR 2016 classification criteria for Sjögren disease (SS) 1 use 5 standard questions on ocular and oral sicca symptoms as an entrance criteria. However, these questions do not differentiate between SS and non-SS sicca etiology. Recently, a new 5-item Sjögren’s Syndrome Screening Questionnaire based on SICCA study data was designed for the use in clinical practice, better differentiating SS from non-SS sicca patienents. 2 Objectives We aimed to validate the SSSQ in our population with sicca symptoms. Methods Our study cohort represented 535 patients referred to UMC Ljubljana during the 3-year period Jan/2016 to Dec/2019 with suspected SS. All subjects underwent at that time a standardized SS diagnostic procedure, including 5 standard sicca questions, Schirmer test, Rose Bengal test, unstimulated salivary flow test, salivary gland ultrasound, immunoserological and lip biopsy. In Sep - Oct 2021 all subjects were contacted by phone to fulfil the new SSSQ (5 questions resulting in 0-11 points: cut-off for SS ≥7 points). The performance of SSSQ recognizing SS was assessed using ACR/EULAR 2016 classification criteria as gold standard test for SS diagnosis. Results 415 out of 525 subjects agreed to participate in the study (384 (92.5%) females, mean (SD) age 57.6(13.8)), the rests either declined (21), died (2) or could not be reached (97). Based on the ACR/EULAR 2016 criteria SS was diagnosed in 127 (30.6%) and excluded in 288 subjects. 376/415 (90.6%) subjects responded positively on 5 standard sicca questions (110 with and 266 without SS). In the new SSSQ 129 (31.1%) subjects (54 with and 75 without SS) responded positively (reached ≥7 points). The performance of SSSQ recognizing SS is presented in Table 1. Table 1. Diagnostic accuracy of SSSQ (Sjögren’s Syndrome Screening Questionnaire) and ACR/EULAR 2016 sicca questions in our cohort. PLR Positive Likelihood Ratio; NLR Negative Likelihood Ratio; PPV Positive Predictive Value; NPV Negative Predictive Value; Statistics SSSQ Standard sicca questionairre Value (95% CI) Value (95%CI) Sensitivity 42.5% (33.8 to 51.6%) 86.6% (79.4 to 92.0%) Specificity 73.7% (68.5 to 78.9%) 7.6% (4.9 to 11.3%) PLR 1.4 (1.2 to 2.2) 0.9 (0.9 to 1.0) NLR 0.8 (0.7 to 0.9) 1.8 (1.0 to 3.2) PPV 41.9% (35.2 to 48.8%) 29.3% (27.7 to 30.9%) NPV 74.5% (71.2 to 77.5%) 56.4% (41.6 to 70.2%) Accuracy 64.3% (59.5 to 69.0%) 31.8% (27.4 to 36.5%) AUC 0.58 (0.52-0.64) 0.52 (0.46-0.57) Conclusion SSSQ showed higher specificity and better diagnostic accuracy compared to current standard questionnaire in a cohort of sicca patients. References [1]Shiboski CH, et al. Arthritis Rheumatol. 2017;69:35–45. [2]Yu K, et al. J Clin Rheumatol 2021; doi: 10.1097/RHU.0000000000001760 Acknowledgements This work was supported by Slovenian National Research Agency grants P3-0314 and J3-3153. Disclosure of Interests None declared
AB1044 RISK FACTORS OF DIABETES MELLITUS IN PATIENTS WITH GOUT (RESULTS OF A PROSPECTIVE STUDY)
Authors: O. Sheliabina, M. Eliseev, S. Glukhova
Journal: Annals of the Rheumatic Diseases (2022)

Background It is assumed that the risk of developing diabetes mellitus (DM) is due not only to generally accepted risk factors (RF), but also to RF related to gout. Objectives To evaluate the influence of various RF for DM in pts with gout. Methods 444 pts aged ≥18 years with a crystal-verified diagnosis of gout without DM were included in the study. The average duration of observation was 5.66 [2.69; 7.4] yrs. To identify the RF associated with developing of DM in patients with gout, multivariate logistic regression was used. There were included: gender; DM in relatives; insufficient physical activity; unbalanced diet; age ≥45 yrs; ≥ 4 exacerbation of arthritis per yr; presence of tophi; BMI ≥ 30 kg/m 2 ; presence of hypertension; allopurinol, febuxostat, GC, diuretics, metformin or colchicine intake; GFR &lt;60 ml/min/1.73 m 2 ; serum uric acid (sUA) level ≥420 µmol/l; UA ≥480 µmol/l. Statistica 12.0 package was used for statistical data processing. Results DM was developed in 108 (24.3%) pts. Pts who developed DM were older than those who did not develop (52.84±10.96 vs 49.72±11.95 respectively, p=0.02); they were more likely to have heredity for DM of the first and second kinship lines (49.1% vs 25.6% respectively, p=0.0001); they took antihypertensive drugs more often (73.1% vs 50.5%, p=0.0001), also diuretics (27.7% vs 14.8%, p =0.003) and GC (47.2% vs 36.4%, p=0.047). There were more pts with subcutaneous tophi (59.3% vs 29.9%, p=0.001), those who had ≥ 4 attacks of arthritis per yr (67.6% vs 31.6%, p=0.001), sUA ≥480 µmol/l (71.3% vs 50.8%, p=0.0002), sUA≥600 µmol/l (34.3% vs 11.8%, p=0.0002). According to a multivariable logistic regression, the risk of DM is increased in case of: ≥ 4 arthritis attacks per yr (odds ratio [OR] 5.231, 95% confidence interval [CI] 2.978-9.187, p=0.0001); presence of subcutaneous tophi (OR 2.609, 95% CI 1.500-4.537, p=0.001); sUA level ≥480 µmol/l (OR 2.261, 95% CI 1.022-5.004, p=0.144); hypertension (OR 2.577, 95% CI 1.348-4.926, p=0.004); taking diuretics (OR 2.353, 95% CI 1.193-4.64, p=0.014). The risk of developing DM was reduced by taking febuxostat (OR 0.309, 95% CI 0.113-0.844, p=0.022) and metformin (OR 0.49 (95% CI 0.21; 1.16), p=0.107). Conclusion The risk of developing DM in pts with gout is associated with the frequency of arthritis attacks, sUA level ≥480 µmol/l, hypertension and diuretics intake. Therapy with febuxostat or metformin is associated with descended risk of DM. Disclosure of Interests Olga Sheliabina Speakers bureau: Berlin Chemie Menarini Group, Maxim Eliseev Speakers bureau: Berlin Chemie Menarini Group, Sobi, EGIS, CSC, MosFarma, Alium Group, Svetlana Glukhova: None declared